Situs inversus, and the difficulty of operating on patients with reversed anatomy

Operating is difficult enough, but imagine doing on someone’s organs that were transposed on the other side.

1 in 10,000 patients have a condition known as situs inversus, where, despite the non-traditional placement of organs, patients function without clinical symptoms.

In this interesting piece from MedPage Today, several surgeons are interviewed about their experiences performing procedures on such patients. For instance, when talking to a heart surgeon who knew what he was dealing with going into a heart transplant, it was “actually very disconcerting to see structures on the wrong side of the chest.” And when you consider how uncommon heart transplants already are (about 2,500 cases a year), doing a transplant on a patient with situs inversus occurs once every few years.

Another interesting scenario would be suspected appendicitis. In most cases, left-sided pain would exclude the condition, except in patients with situs inversus. In effect, according to a thoracic surgeon, “Each one of these patients has essentially an anatomy that’s never been seen before, because they all have slight variations, almost like fingerprints, so it’s hard to generalize.”

Although these cases can be unexpected, most operations do fine. Surgeons liken it to a riddle that needs to be solved, and life-threatening events arising from the condition are rare.